PDPM Audit Optimization Group™ defends skilled nursing facilities against every major federal and state audit type — while training your entire team to prevent findings before they happen.
Every service PDPM Audit Optimization Group™ provides is designed around one principle: your facility should never be surprised by an audit. We build the defense before the auditor arrives.
When a federal or state audit arrives, your documentation is already organized, your staff is already trained, and your defense is already written. PDPM Audit Group™ prepares you before — not during. Every audit type, every documentation requirement, every appeals pathway — covered under one agreement.
Your MDS is the foundation of everything — reimbursement, quality metrics, audit exposure. We review every section, identify documentation patterns that create risk, and train your coordinators on current CMS expectations.
State health inspections and federal certification surveys create significant compliance risk. We monitor regulatory changes in real time and ensure your facility documentation meets every current standard before surveyors arrive.
Every role in your facility — from the administrator to the dietary aide — receives targeted compliance training each quarter. Training is specific to their role, current regulations, and your facility's specific risk profile.
Your administrator and leadership team receive a full compliance and billing performance report every month — with documented improvements, upcoming regulatory changes, and a proactive plan already in place.
Physicians are one of the highest-risk documentation gaps in any SNF. Our 1-on-1 physician training sessions focus on order documentation, diagnosis specificity, and the connection between physician notes and MDS coding.
Post-payment reviews targeting improper Medicare and Medicaid payments. High-dollar overpayment demands with aggressive collection timelines.
CMS pre-payment and post-payment reviews targeting facilities with identified billing patterns. Escalates to Additional Documentation Requests.
Federal investigations into fraud, waste, and abuse. Can result in exclusion from Medicare/Medicaid and significant civil monetary penalties.
Annual CMS program measuring improper payment rates. CERT findings directly influence future RAC and TPE targeting of your facility.
Investigates potential fraud and abuse across Medicare and Medicaid. Has authority to request medical records and interview staff.
MDS accuracy and completion audits. Errors in RAI documentation directly affect PDPM reimbursement and quality measure scores.
CMS staffing data reporting compliance. Inaccurate PBJ submissions affect Five-Star ratings and trigger additional regulatory scrutiny.
Annual health inspections, complaint investigations, and life safety surveys. Deficiencies affect certification status and public Five-Star rating.
Compliance failures almost always trace back to staff who were not trained on current requirements. PDPM Audit Group™ trains every role in your facility — not just clinical staff — every single quarter, with content updated to reflect the latest CMS guidance.
Fixed monthly fees scaled to your facility size. Every plan includes the full scope of compliance defense, staff training, and RevOptix1™ technology access. No hidden fees, no per-audit charges.
| Plan | Facility Size | Monthly Fee | What's Included |
|---|---|---|---|
|
Small
|
Under 75 beds |
$3,500
per month
|
|
|
Most Popular
Medium
|
76–150 beds |
$5,000
per month
|
|
|
Large
|
151–200 beds |
$8,000
per month
|
|
|
Enterprise
|
201+ beds |
$12,000
per month
|
|
PDPM Audit Group and RevOptix1 have a fixed-fee incentive advantage program for meeting jointly defined operational milestones. Facilities that choose to participate pay PDPM Audit Group and RevOptix1 incentives structured quarterly, semi-annually, or annually — a performance-aligned model that rewards measurable outcomes and creates a shared interest in your facility's financial success.
Human expertise and AI technology working together — the complete SNF revenue and compliance defense system.
Compliance auditing, audit defense, staff training, leadership meetings, physician training, regulatory monitoring, and iQIES documentation.
AI-powered ICD-10 gap analysis, patient chart scanning, revenue recovery reports, physician order dashboard, and staff communications platform.
Together, they form a complete system that finds every missed dollar and defends every audit — the only SNF solution that covers both revenue and compliance in one agreement.
Learn About RevOptix1™ →Most SNFs discover their compliance gaps during an audit — not before. PDPM Audit Group™ finds them first, fixes them proactively, and defends you when it counts.
Schedule Your ConsultationTell us about your facility and we'll reach out within 24 hours to schedule your free compliance assessment.
Thank you — a member of our team will reach out within 24 hours to confirm your consultation.
Questions? Email consultation@pdpmauditgroup.com